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Van Orden KA, Conwell Y, Chapman BP, Buttaccio A, VanBergen A, Beckwith E, Santee A, Rowe J, Palumbos D, Williams G, Messing S, Sörensen S, Tu X. The helping older people engage (HOPE) study: Protocol & COVID modifications for a randomized trial. Contemp Clin Trials Commun 2022; 30:101040. [PMID: 36479062 PMCID: PMC9720528 DOI: 10.1016/j.conctc.2022.101040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 10/31/2022] [Accepted: 11/27/2022] [Indexed: 12/02/2022] Open
Abstract
Objectives Evidence-based strategies to reduce loneliness in later life are needed because loneliness impacts all domains of health, functioning, and quality of life. Volunteering is a promising strategy, as a large literature of observational studies documents associations between volunteering and better health and well-being. However, relatively few studies have used randomized controlled trials (RCTs) to examine benefits of volunteering, and none have examined loneliness. The primary objective of the Helping Older People Engage (HOPE) study is to examine the social-emotional benefits of a social volunteering program for lonely older adults. This manuscript describes the rationale and design of the trial. Methods We are randomly assigning adults aged 60 or older (up to 300) who report loneliness to 12 months of either AmeriCorps Seniors volunteering program or an active control (self-guided life review). Co-primary outcomes are assessed via self-report-loneliness (UCLA Loneliness Scale) and quality of life (WHOQOL-Bref). Enrollment was completed in May 2022 and follow-up assessments will continue through May 2023, with completion of primary outcomes soon thereafter. Conclusions Since older adults who report loneliness are less likely to actively seek out volunteering opportunities, if results support efficacy of volunteering for reducing loneliness, dissemination and scaling up efforts may involve connecting primary care patients who are lonely with AmeriCorps Seniors through aging services agencies.This RCT is registered at clinicaltrials.gov (NCT03343483).
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Messing S, Tcymbal A, Abu-Omar K, Richardson D, Gelius P. Methods of policy monitoring in physical activity promotion: a systematic review across different levels of government. Eur J Public Health 2022. [PMCID: PMC9594761 DOI: 10.1093/eurpub/ckac129.269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background Even though the importance of policy monitoring in public health has increased in the last decades, there is still a lack of understanding what different approaches of policy monitoring exist and which methodology they employ. In order to address this research gap, this review attempts to provide a comprehensive overview about the methods of policy monitoring in the field of physical activity promotion. Methods A systematic search was conducted in five scientific databases, using the terms “physical activity”, “policy” and “monitoring” and their variations. In total, 12.963 studies were identified and, after the elimination of duplicates, screened independently by two reviewers. During full text analysis, information on the methods applied for policy monitoring was extracted and studies were categorized based on their key characteristics (monitoring tool, policy level, and setting). Results The search yielded in a total of 112 studies that were structured into seven categories: Report Cards on Physical Activity for Children and Youth, HEPA Monitoring Framework, HEPA Policy Audit Tool, national policies, subnational policies, school setting, and childcare setting. Across all categories, policy monitoring focused mainly on national level policies in a single country. Differences were identified with regards to the level of government involvement which allowed to differentiate between research-driven approaches (little or no government involvement), government-driven approaches (led by governments), and co-production approaches (strong collaboration between researchers and governments). Conclusions Research-driven, government-driven and co-production approaches have different strengths and weaknesses with regards to the monitoring of policies. Awareness needs to be raised regarding the implications of these approaches, and more research is needed to analyse the impact of policy monitoring on policy-making in public health.
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Affiliation(s)
- S Messing
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürn , Erlangen, Germany
| | - A Tcymbal
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürn , Erlangen, Germany
| | - K Abu-Omar
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürn , Erlangen, Germany
| | - D Richardson
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürn , Erlangen, Germany
| | - P Gelius
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürn , Erlangen, Germany
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Woods C, Kelly L, Volf K, Gelius P, Messing S, Forberger S, Lakerveld J, den Braver N, Zukowska J. The development of the Physical Activity Environment Policy Index (PA-EPI): a tool for monitoring and benchmarking government policies and actions to improve physical activity. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac129.270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Insufficient physical activity (PA) is a global issue for health. A multifaceted response, including government action, is essential to improve population levels of PA. The purpose of this study was to develop the ‘Physical Activity Environment Policy Index’ (PA-EPI) monitoring framework to assess government policies and actions for creating a healthy PA environment.
Methods
An iterative process was undertaken. This involved a review of policy documents from authoritative organisations, a policy audit of four European countries, and systematic reviews of scientific literature. This was followed by an online consultation with academic experts (N = 101; 20 countries, 72% response rate), and policymakers (N = 40, 4 EU countries). During this process, consensus workshops where quantitative and qualitative data alongside theoretical and pragmatic considerations were used to inform PA-EPI development.
Results
The PA-EPI is conceptualised as a two-component ‘policy’ and ‘infrastructure support’ framework. The two components comprise eight policy and seven infrastructure support domains. The policy domains are education, transport, urban design, healthcare, public education (including mass media), sport-for-all, workplaces and community. The infrastructure support domains are leadership, governance, monitoring and intelligence, funding and resources, platforms for interaction, workforce development, and health-in-all-policies. Forty-five ‘good practice statements’ (GPS) or indicators of ideal good practice within each domain concludes the PA-EPI. A potential eight-step process for conducting the PA-EPI is described.
Conclusions
Once pre-tested and piloted in several countries of various sizes and income levels, the PA-EPI GPS will evolve into benchmarks established by governments at the forefront of creating and implementing policies to address inactivity.
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Affiliation(s)
- C Woods
- Physical Activity for Health Research Cluster, University of Limerick , Limerick, Ireland
| | - L Kelly
- Physical Activity for Health Research Cluster, University of Limerick , Limerick, Ireland
| | - K Volf
- Physical Activity for Health Research Cluster, University of Limerick , Limerick, Ireland
| | - P Gelius
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen- Nürnberg , Erlangen, Germany
| | - S Messing
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen- Nürnberg , Erlangen, Germany
| | - S Forberger
- Leibniz Institute for Prevention Research and Epidemiology , Bremen, Germany
| | - J Lakerveld
- Department of Epidemiology and Data Science, Amsterdam UMC, VU University Amsterdam , Amsterdam, Netherlands
- Upstream Team, VU University Amsterdam , Amsterdam, Netherlands
| | - N den Braver
- Department of Epidemiology and Data Science, Amsterdam UMC, VU University Amsterdam , Amsterdam, Netherlands
- Upstream Team, VU University Amsterdam , Amsterdam, Netherlands
| | - J Zukowska
- Faculty of Civil and Environmental Engineering, Gdansk University of Technology , Gdansk, Poland
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Conwell Y, Van Orden KA, Stone DM, McIntosh WL, Messing S, Rowe J, Podgorski C, Kaukeinen KA, Tu X. Peer Companionship for Mental Health of Older Adults in Primary Care: A Pragmatic, Nonblinded, Parallel-Group, Randomized Controlled Trial. Am J Geriatr Psychiatry 2021; 29:748-757. [PMID: 32586693 PMCID: PMC7266585 DOI: 10.1016/j.jagp.2020.05.021] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 05/20/2020] [Accepted: 05/20/2020] [Indexed: 10/25/2022]
Abstract
OBJECTIVES To determine whether peer companionship delivered by an aging services agency to socially-disconnected older adult primary care patients was associated with improvement in suicidal ideation depression, anxiety, and psychological connectedness. DESIGN Pragmatic, nonblinded, parallel-group, randomized controlled trial comparing peer companionship, The Senior Connection (TSC), to care-as-usual (CAU). SETTING Lifespan, a nonmedical, community-based aging services agency. PARTICIPANTS Adult primary care patients ages 60 years or older who endorsed feelings of loneliness or being a burden on others. INTERVENTION TSC was delivered by Lifespan volunteers who provided supportive visits and phone calls in the subjects' homes. CAU involved no peer companion assignment. MEASUREMENTS The primary outcome was suicidal ideation assessed by the Geriatric Suicide Ideation Scale; secondary outcomes were depression, anxiety, and feelings of belonging and being a burden on others. Data were collected at baseline, 3-, 6-, and 12-months. RESULTS Subjects (55% female) had a mean age of 71 years. There was no difference between groups in change in suicidal ideation or belonging. Subjects randomized to TSC had greater reduction in depression (PHQ-9; 2.33 point reduction for TSC versus 1.32 for CAU, p = 0.05), anxiety (GAD-7; TSC 1.52 versus CAU 0.28, p = 0.03), and perceived burden on others (INQ; 0.46 TSC versus 0.09 CAU, p <0.01). CONCLUSIONS TSC was superior to CAU for improving depression, anxiety, and perceived burden, but not suicidal ideation. Although effect sizes were small, the low-cost and nationwide availability of peer companionship justify further examination of its effectiveness and scalability in improving mental health outcomes of socially disconnected older adults.
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Affiliation(s)
- Yeates Conwell
- Department of Psychiatry (YC, KVO, and CP), University of Rochester School of Medicine, Rochester, NY.
| | - Kimberly A Van Orden
- Department of Psychiatry (YC, KVO, and CP), University of Rochester School of Medicine, Rochester, NY
| | - Deborah M Stone
- Division of Injury Prevention (DMS, WLKWM), Centers for Disease Control and Prevention, Atlanta, GA
| | - Wendy LiKamWa McIntosh
- Division of Injury Prevention (DMS, WLKWM), Centers for Disease Control and Prevention, Atlanta, GA
| | - Susan Messing
- Department of Biostatistics and Computational Biology (SM, KAK), University of Rochester School of Medicine, NY
| | - Jody Rowe
- Lifespan of Greater Rochester, Inc. (JR), NY
| | - Carol Podgorski
- Department of Psychiatry (YC, KVO, and CP), University of Rochester School of Medicine, Rochester, NY
| | - Kimberly A Kaukeinen
- Department of Biostatistics and Computational Biology (SM, KAK), University of Rochester School of Medicine, NY
| | - Xin Tu
- Department of Family Medicine and Public Health, Division of Biostatistics and Bioinformatics (XT), UC San Diego School of Medicine, La Jolla, CA
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Yurcheshen ME, Pigeon W, Marcus CZ, Marcus JA, Messing S, Nguyen K, Marsella J. Interrater reliability between in-person and telemedicine evaluations in obstructive sleep apnea. J Clin Sleep Med 2021; 17:1435-1440. [PMID: 33687321 PMCID: PMC8314612 DOI: 10.5664/jcsm.9220] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 02/19/2021] [Accepted: 02/19/2021] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES We examined how telemedicine evaluation compares to face-to-face evaluation in identifying risk for sleep-disordered breathing. METHODS This was a randomized interrater reliability study of 90 participants referred to a university sleep center. Participants were evaluated by a clinician investigator seeing the patient in-person, then randomized to a second clinician investigator who performed a patient evaluation online via audio-video conferencing. The primary comparator was pretest probability for obstructive sleep apnea. RESULTS The primary outcome comparing pretest probability for obstructive sleep apnea showed a weighted kappa value of 0.414 (standard error 0.090, P = .002), suggesting moderate agreement between the 2 raters. Kappa values of our secondary outcomes varied widely, but the kappa values were lower for physical exam findings compared to historical elements. CONCLUSIONS Evaluation for pretest probability for obstructive sleep apnea via telemedicine has a moderate interrater correlation with in-person assessment. A low degree of interrater reliability for physical exam elements suggests telemedicine assessment for obstructive sleep apnea could be hampered by a suboptimal physical exam. Employing standardized scales for obstructive sleep apnea when performing telemedicine evaluations may help with risk-stratification and ultimately lead to more tailored clinical management.
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Affiliation(s)
| | - Wilfred Pigeon
- University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Carolina Z. Marcus
- University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Jonathan A. Marcus
- University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Susan Messing
- University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Kevin Nguyen
- Saddleback Medical Center, Laguna Hills, California
| | - Jennifer Marsella
- University of Rochester School of Medicine and Dentistry, Rochester, New York
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Yurcheshen M, Pigeon W, Marcus C, Marcus J, Messing S, Nguyen K, Marsella J. 805 Towards a more perfect union: interrater reliability between telemedicine and in-person evaluators in sleep disordered breathing. Sleep 2021. [DOI: 10.1093/sleep/zsab072.802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Telemedicine has rapidly changed the landscape of all of clinical practice, and is now widely employed in sleep medicine. To date, the accuracy of telemedicine in identifying patients at risk for obstructive sleep apnea (OSA) is still unknown. Given differences in technique and fidelity, a perfect correlation between these two types of encounters cannot be assumed. We studied how providers using a telemedicine platform compared to providers using traditional in-person encounters in identifying risk for sleep disordered breathing.
Methods
90 participants referred to a comprehensive university sleep program were randomized to this interrater reliability study. Subjects were representative of the gender and ethnic breakdown of the outlying community. The subjects were evaluated by an in-person clinician investigator, then randomized to a second clinician investigator who performed an evaluation online using a common teleconferencing platform. Both types of evaluations included a history and physical exam. The primary outcome was pretest probability for obstructive sleep apnea. Secondary comparators included level of daytime sleepiness, snoring volume, apneas witnessed by a third party, modified Mallampati score, presence/absence of tonsils, degree of overjet bite, and severity of apnea based on home sleep testing.
Results
Interrater reliability for pretest probability of OSA was reflected in a weighted kappa value of 0.414 (SE 0.090, p=0.002). This suggests moderate agreement between the an in-person and telemedicine evaluator. Kappa values of our secondary outcomes ranged from -0.044 (degree of maxillary overjet) to 0.702 (apneas witnessed by a third party), and were generally higher for historical elements and lower for physical exam findings.
Conclusion
Evaluation for pretest probability for sleep apnea via telemedicine has a moderate interrater correlation with in-person assessment. A relatively high degree of interrater reliability for historical elements suggests that the accuracy of telemedicine for OSA is tempered by a suboptimal physical exam. Telemedicine evaluations might become more accurate through standardization. For instance, using validated scales for OSA or templated encounter scripts may help with risk-stratification, and ultimately lead to more uniform management.
Support (if any)
This study was supported by an AASM Foundation Focused Project Award
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Guttuso T, Messing S, Tu X, Mullin P, Shepherd R, Strittmatter C, Saha S, Thornburg LL. Effect of gabapentin on hyperemesis gravidarum: a double-blind, randomized controlled trial. Am J Obstet Gynecol MFM 2020; 3:100273. [PMID: 33451591 DOI: 10.1016/j.ajogmf.2020.100273] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 10/21/2020] [Accepted: 10/22/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND Hyperemesis gravidarum is a disabling disease of nausea, vomiting, and undernutrition in early pregnancy for which there are no effective outpatient therapies. Poor weight gain in hyperemesis gravidarum is associated with several adverse fetal outcomes including preterm delivery, low birthweight, small for gestational age, low 5-minute Apgar scores, and neurodevelopmental delay. Gabapentin is most commonly used clinically for treating neuropathic pain but also substantially reduces chemotherapy-induced and postoperative nausea and vomiting. Pregnancy registry data have shown maternal first-trimester gabapentin monotherapy to be associated with a 1.2% rate of major congenital malformations among 659 infants, which compares favorably with the 1.6% to 2.2% major congenital malformation rate in the general population. Open-label gabapentin treatment in hyperemesis gravidarum was associated with reduced nausea and vomiting and improved oral nutrition. OBJECTIVE This study aimed to determine whether gabapentin is more effective than standard-of-care therapy for treating hyperemesis gravidarum. STUDY DESIGN A double-blind, randomized, multicenter trial was conducted among patients with medically refractory hyperemesis gravidarum requiring intravenous hydration. Patients were randomized (1:1) to either oral gabapentin (1800-2400 mg/d) or an active comparator of either oral ondansetron (24-32 mg/d) or oral metoclopramide (45-60 mg/d) for 7 days. Differences in Motherisk-pregnancy-unique quantification of nausea and emesis total scores between treatment groups averaged over days 5 to 7, using intention-to-treat principle employing a linear mixed-effects model adjusted for baseline Motherisk-pregnancy-unique quantification of nausea and emesis scores, which served as the primary endpoint. Secondary outcomes included Motherisk-pregnancy-unique quantification of nausea and emesis nausea and vomit and retch subscores, oral nutrition, global satisfaction of treatment, relief, desire to continue therapy, Nausea and Vomiting of Pregnancy Quality of Life, and Hyperemesis Gravidarum Pregnancy Termination Consideration. Adjustments for multiple comparisons were made employing the false discovery rate. RESULTS A total of 31 patients with hyperemesis gravidarum were enrolled from October 2014 to May 2019. Among the 21 patients providing primary outcome data (12 assigned to gabapentin and 9 to the active comparator arm), 18 were enrolled as outpatients and all 21 were outpatients from days 5 to 7. The study groups' baseline characteristics were well matched. Gabapentin treatment provided a 52% greater reduction in days 5 to 7 baseline adjusted Motherisk-pregnancy-unique quantification of nausea and emesis total scores than treatment with active comparator (95% confidence interval, 16-88; P=.01). Most secondary outcomes also favored gabapentin over active comparator treatment including 46% and 49% decreases in baseline adjusted Motherisk-pregnancy-unique quantification of nausea and emesis nausea (95% confidence interval, 19-72; P=.005) and vomit and retch subscores (95% confidence interval, 21-77; P=.005), respectively; a 96% increase in baseline adjusted oral nutrition scores (95% confidence interval, 27-165; P=.01); and a 254% difference in global satisfaction of treatment (95% confidence interval, 48-459; P=.03). Relief (P=.06) and desire to continue therapy (P=.06) both showed trends favoring gabapentin treatment but Nausea and Vomiting of Pregnancy Quality of Life (P=.68) and Hyperemesis Gravidarum Pregnancy Termination Consideration (P=.58) did not. Adverse events were roughly equivalent between the groups. There were no serious adverse events. CONCLUSION In this small trial, gabapentin was more effective than standard-of-care therapy for reducing nausea and vomiting and increasing oral nutrition and global satisfaction in outpatients with hyperemesis gravidarum. These data build on previous findings in other patient populations supporting gabapentin as a novel antinausea and antiemetic therapy and support further research on gabapentin for this challenging complication of pregnancy.
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Affiliation(s)
- Thomas Guttuso
- Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY.
| | - Susan Messing
- Department of Biostatistics and Computational Biology, University of Rochester, Rochester, NY
| | - Xin Tu
- Division of Biostatistics and Bioinformatics, Department of Family Medicine and Public Health, University of California, San Diego, San Diego, CA
| | - Patrick Mullin
- Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Rachel Shepherd
- Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY
| | - Chad Strittmatter
- Department of Obstetrics and Gynecology, Sisters of Charity Hospital, Buffalo, NY
| | - Sumona Saha
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Loralei L Thornburg
- Department of Obstetrics and Gynecology, University of Rochester, Rochester, NY
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Volf K, Kelly L, García Bengoechea E, Gobis A, Lakerveld J, Zukowska J, Gelius P, Messing S, Forberger S, Woods C. Systematic review examining the evidence for impact of school policies on physical activity. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.1138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Epidemiological evidence has demonstrated that physical activity can have substantive health benefits for children and young people. The 'Policy Evaluation Network' is a multi-disciplinary research network across 7 European countries and New Zealand aimed at building capacity and evaluating the level of impact of policy interventions for promoting healthy lifestyles. The Toronto Charter identified 'whole-of-school' programmes as one of seven key investments for promotion of PA. This paper presents results of a SLR, designed to assess the level of evidence for policies within the school setting that contribute directly or indirectly to increasing PA.
Methods
Researchers searched six online databases for scientific literature regarding PA policy interventions in the school setting using key concepts of policy, school, PA and evaluation. Risk of bias will be assessed with tools appropriate to the design of the studies considered. Evidence of actual or potential positive PA outcomes arising directly or indirectly from policy actions will be catalogued.
Results
Preliminary searches identified 2327 unique scientific articles. 1938 (83.3%) were excluded on first reading and 189 (8.8%) were included for full text analysis. Initial findings suggest that organisational policies, for example avoiding overcrowding in playgrounds during school breaks, may be a promising policy action. Detailed analysis revealing other potential policy actions supported by evidence will be presented (SLR in progress).
Conclusions
Preliminary findings suggest that few studies link policy actions in the school setting to PA outcomes. However, studies that have investigated the effects of changes to the school environment on PA levels may provide evidence for policy actions. Preliminary recommendations include strengthening the evidence base for school-based PA policy by supporting studies into the effects of particular policy or legislative changes on PA outcomes.
Key messages
School physical activity policies are an underappreciated public health intervention. More studies should link policy changes to physical activity outcomes.
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Affiliation(s)
- K Volf
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
| | - L Kelly
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
| | - E García Bengoechea
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
| | - A Gobis
- Faculty of Civil and Environmental Engineering, Gdansk University of Technology, Gdansk, Poland
| | - J Lakerveld
- Amsterdam University Medical Center, Amsterdam, Netherlands
| | - J Zukowska
- Faculty of Civil and Environmental Engineering, Gdansk University of Technology, Gdansk, Poland
| | - P Gelius
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - S Messing
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - S Forberger
- Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany
| | - C Woods
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
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Forberger S, Gelius P, Messing S, Volf K, Kelly L, Taylor S, Zukowska J, Lakerveld J, Woods C. Sub-national structures matter when evaluating physical activity promotion: Lessons from Germany. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Public policies are increasingly acknowledged as important part of promoting physical activity (PA). However, especially in states with sub-national administrative structures such as Germany, national and sub-national approaches differ considerably. In Germany, sport for all (SfA) promotion is mostly organized at sub-national level, which is usually not covered in national evaluations. Knowledge of these structures helps to understand national outcomes, enables comparisons and learning within and between countries, and assists in identifying support structures for effective PA promotion.
Methods
Data were collected in the PEN Policy Evaluation Network project. In addition to the WHO HEPA PAT, a questionnaire was sent to the sports representatives of the 16 federal states. Responses of 11 state representatives were included and overarching issues were identified using inductive thematic analysis.
Results
PA promotion in Germany is organized in three areas: SfA, professional sports and school sports. SfA promotion at sub-national level is assigned to different administrative bodies (ministries, senate administration, state chancellery) and policy areas: culture, health and care, home affairs with various aspects, education, social affairs and family. The priorities of the federal states are more diverse and specific compared to the national level. There is an overlap in the topics: urban planning, cycling, health prevention and targeting children. Cooperation mechanisms and partners vary between federal states, but some partners are active at sub-national and national level.
Conclusions
The results provide an insight into the complexity of PA and especially SfA promotion at sub-national level in Germany. Our results suggest that a broader range of approaches is used in the 16 German states than national overviews would suggest. These particularities must be taken into account when assessing and comparing the results from different countries.
Key messages
The promotion of SfA at German sub-national level is much more diverse than represented at national level evaluations. Knowledge of sub-national structures enables the understanding of national outcomes, the promotion of cross-national learning and the identification of supportive structures for effective PA promotion.
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Affiliation(s)
- S Forberger
- BIPS, Leibniz Institute for Prevention Research and Epidemiology, Bremen, Germany
| | - P Gelius
- FAU, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - S Messing
- FAU, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - K Volf
- Physical Activity for Health, Health Research Institute, Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
| | - L Kelly
- Physical Activity for Health, Health Research Institute, Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
| | - S Taylor
- Physical Activity for Health, Health Research Institute, Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
| | - J Zukowska
- Faculty of Civil and Environmental Engineering, Gdansk University of Technology, Gdansk, Poland
| | - J Lakerveld
- VUmc, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - C Woods
- Physical Activity for Health, Health Research Institute, Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
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10
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Bravo-Jaimes K, Loescher VY, Canelo-Aybar C, Rojas-Camayo J, Mejia CR, Schult S, Nieto R, Singh K, Messing S, Hinostroza J. Effect of altitude on mortality of end-stage renal disease patients on hemodialysis in Peru. Clin Kidney J 2020; 14:998-1003. [PMID: 33777381 PMCID: PMC7986442 DOI: 10.1093/ckj/sfaa056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 03/23/2020] [Indexed: 11/11/2022] Open
Abstract
Background In Latin America, the prevalence of end-stage kidney disease (ESKD) has risen tremendously during the last decade. Previous studies have suggested that receiving dialysis at high altitude confers mortality benefits; however, this effect has not been demonstrated at >2000 m above sea level (masl) or in developing countries. Methods This historical cohort study analyzed medical records from six Peruvian hemodialysis (HD) centers located at altitudes ranging from 44 to 3827 masl. Adult ESKD patients who started maintenance HD between 2000 and 2010 were included. Patients were classified into two strata based on the elevation above sea level of their city of residence: low altitude (<2000 masl) and high altitude (≥2000 masl). Death from any cause was collected from national registries and Cox proportional hazards models were built. Results A total of 720 patients were enrolled and 163 (22.6%) resided at high altitude. The low-altitude group was significantly younger, more likely to have diabetes or glomerulonephritis as the cause of ESKD and higher hemoglobin. The all-cause mortality rate was 84.3 per 1000 person-years. In the unadjusted Cox model, no mortality difference was found between the high- and low-altitude groups {hazard ratio [HR] 1.20 [95% confidence interval (CI) 0.89-1.62]}. After multivariable adjustment, receiving HD at high altitude was not significantly associated with higher mortality, but those with diabetes as the cause of ESKD had significantly higher mortality [HR 2.50 (95% CI 1.36-4.59)]. Conclusions In Peru, patients receiving HD at high altitudes do not have mortality benefits.
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Affiliation(s)
- Katia Bravo-Jaimes
- Division of Cardiovascular Medicine, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Viky Y Loescher
- Department of Radiology, Mount Sinai Hospital, Miami, FL, USA
| | - Carlos Canelo-Aybar
- Institut d'Investigacions Biomèdiques Sant Pau (IIB- Sant Pau), Cochrane Iberoamerican Center, Barcelona, Spain
| | - Jose Rojas-Camayo
- Instituto de Investigaciones de la Altura, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Christian R Mejia
- School of Health Sciences, Universidad Continental, Huancayo, Junin, Peru
| | | | - Ruben Nieto
- Division of Nephrology, EsSalud Cusco, Cusco, Peru
| | - Kyra Singh
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY, USA
| | - Susan Messing
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY, USA
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11
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O’Connor TG, Willoughby MT, Moynihan JA, Messing S, Vallejo Sefair A, Carnahan J, Yin X, Caserta MT. Early childhood risk exposures and inflammation in early adolescence. Brain Behav Immun 2020; 86:22-29. [PMID: 31059804 PMCID: PMC6825880 DOI: 10.1016/j.bbi.2019.05.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 04/26/2019] [Accepted: 05/02/2019] [Indexed: 02/06/2023] Open
Abstract
There is now reliable evidence that early psychosocial stress exposures are associated with behavioral health in children; the degree to which these same kinds of stress exposures predict physical health outcomes is not yet clear. We investigated the links between economic adversity, family and caregiving stress in early childhood and several markers of immune function in early adolescence. The sample is derived from the Family Life Project, a prospective longitudinal study of at-risk families. Socio-demographic and psychosocial risks have been assessed at regular intervals since the children were first assessed at 2 months of age. When the children were early adolescents, we conducted an in-depth health assessment of a subsample of families; blood samples were collected from venipuncture for interleukin(IL)-6, Tumor Necrosis Factor (TNF)-alpha, and C-reactive protein (CRP), as well as glucocorticoid resistance. Results indicated limited but reliable evidence of an association between early risk exposure and inflammation in adolescence. Specifically, caregiver depressive symptoms in early childhood predicted elevated CRP almost a decade later, and the prediction was significant after accounting for multiple covariates such as socio-economic adversity, health behaviors and body mass index. Our findings provide strong but limited evidence that early stress exposures may be associated with inflammation, suggesting one mechanism linking early stress exposure to compromised behavioral and somatic health.
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Affiliation(s)
| | | | - Jan A Moynihan
- Department of Psychiatry, University of Rochester Medical Center
| | - Susan Messing
- Department of Statistics and Bioinformatics, University of Rochester Medical Center
| | | | | | - Xiajuan Yin
- Frank Porter Graham Child Development Institute, University of North Carolina at Chapel Hill
| | - Mary T Caserta
- Department of Pediatrics, University of Rochester Medical Center
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12
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Fortuna RJ, Johnson W, Clark JS, Messing S, Flynn S, Judge SR. Impact of Patient-Centered Medical Home Transformation on Providers, Staff, and Quality. Popul Health Manag 2020; 24:207-213. [PMID: 32208969 DOI: 10.1089/pop.2020.0007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The Patient-Centered Medical Home (PCMH) has become a widely implemented model to transform the delivery of care, but little evidence exists regarding the model's impact on providers, nurses, and staff. This study examined the impact of the PCMH model on (1) provider and staff satisfaction, (2) work-life balance, (3) teamwork, (4) professional experience, (5) patient care factors, and (6) quality outcomes. The authors confidentially surveyed physicians, advanced practice providers (APPs), nurses, care managers, and office staff in 2011 prior to implementation of the PCMH model and in 2016 after implementation at 34 primary care offices providing care to 171,045 patients. A total of 349 pre-PCMH implementation surveys (84% response rate) and 549 follow-up surveys (92% response rate) were received. Implementation of the PCMH model did not result in changes in provider, nurse, and staff responses to composite measures of satisfaction (P = 0.45), work-life balance (P = 0.68), teamwork (P = 0.26), patient care (P = 0.62), or professional experience (P = 0.14). Physicians and APPs experienced a negative, but mostly nonsignificant, change in all composite measures with implementation of the PCMH model. Quality markers improved for diabetes control HbA1c <8 (62.6% to 67.9%; P < 0.001), hypertension control (60.9% to 75.0%; P < 0.001), breast cancer screening (53.9% to 77.4%; P < 0.001), and colorectal cancer screening (43.9% to 70.3%; P < 0.001). Across a large primary care network, implementation of the PCMH model failed to improve overall satisfaction, work-life balance, teamwork, patient care, or professional experience. The model, combined with financial incentives, did result in improvements across multiple patient quality domains.
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Affiliation(s)
- Robert J Fortuna
- Center for Primary Care, University of Rochester, Rochester, New York, USA.,Department of Internal Medicine and Pediatrics, University of Rochester, Rochester, New York, USA
| | - Wallace Johnson
- Center for Primary Care, University of Rochester, Rochester, New York, USA
| | - John S Clark
- Center for Primary Care, University of Rochester, Rochester, New York, USA
| | - Susan Messing
- Department of Biostatistics and Computational Biology, University of Rochester, Rochester, New York, USA
| | - Sheri Flynn
- Center for Primary Care, University of Rochester, Rochester, New York, USA
| | - Stephen R Judge
- Center for Primary Care, University of Rochester, Rochester, New York, USA
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13
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Mahmood B, Chongshu C, Qiu X, Messing S, Hammert WC. Comparison of the Michigan Hand Outcomes Questionnaire, Boston Carpal Tunnel Questionnaire, and PROMIS Instruments in Carpal Tunnel Syndrome. J Hand Surg Am 2019; 44:366-373. [PMID: 30581054 DOI: 10.1016/j.jhsa.2018.10.031] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 09/07/2018] [Accepted: 10/30/2018] [Indexed: 02/02/2023]
Abstract
PURPOSE Patient-reported outcomes are important to assess improvement after surgery. Common instruments for carpal tunnel syndrome include the Michigan Hand Outcomes Questionnaire (MHQ) and Boston Carpal Tunnel Questionnaire (CTQ). The Patient-Reported Outcomes Measurement Information System (PROMIS) are newer measures. We evaluated how the PROMIS Pain Interference (PI) and Upper Extremity (UE) scores change after carpal tunnel release. METHODS All adult patients with carpal tunnel syndrome treated surgically were asked to participate in this prospective study. PROMIS instruments, MHQ, and CTQ were completed by 101 patients. Estimated means and standard errors were calculated, and piecewise linear fixed effects regression models were applied to the data. Standardized response means were calculated for each outcome measure. RESULTS The MHQ Total Score did not show a considerable change from the preoperative to 1-week postoperative visit but improved from the 1-week to 3-month postoperative visit (55 to 80). The CTQ Functional Status Score (FSS) worsened from 2.3 preoperatively to 2.6 at the 1-week postoperative visit before improving through the 3-month postoperative visit (1.6). PROMIS UE showed responsiveness similar to the CTQ FSS with a decline at the 1-week visit, 38 to 33, followed by improvement (45 at 3 mo). However, the standardized response mean values were greater for the CTQ FSS compared with PROMIS UE. The average administration time was shortest for PROMIS UE. The CTQ Symptom Severity Scale and MHQ Pain Scores showed improvements as early as the 1-week visit. The CTQ Symptom Severity Scale improved from 3.1 to 2.3, and MHQ Pain Scores improved from 55 to 46. PROMIS PI did not change at the 1-week visit but improved at 6 weeks and 3 months, from 56 to 52 and 49. The standardized response means for PROMIS PI achieved a large effect size only at 3 months. CONCLUSIONS The CTQ FSS is more responsive than PROMIS UE and the MHQ, with the CTQ FSS showing the largest effect sizes. PROMIS PI does not show the responsiveness seen in the CTQ Symptom Severity Scale and MHQ Pain Score. PROMIS instruments require less time to complete. CLINICAL RELEVANCE This study demonstrates the change in PROMIS scores after carpal tunnel release and how they compare with legacy outcome instruments.
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Affiliation(s)
- Bilal Mahmood
- Department of Orthopaedics and Rehabilitation, University of Rochester, Rochester, NY
| | - Chen Chongshu
- Department of Biostatistics and Computational Biology, University of Rochester, Rochester, NY
| | - Xing Qiu
- Department of Biostatistics and Computational Biology, University of Rochester, Rochester, NY
| | - Susan Messing
- Department of Biostatistics and Computational Biology, University of Rochester, Rochester, NY
| | - Warren C Hammert
- Department of Orthopaedics and Rehabilitation, University of Rochester, Rochester, NY.
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14
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Fortuna RJ, Marston B, Messing S, Wagoner G, Pulcino TL, Bingemann T, Caiola E, Scofield S, Nead K, Robbins BW. Ambulatory Training Program to Expand Procedural Skills in Primary Care. J Med Educ Curric Dev 2019; 6:2382120519859298. [PMID: 31309160 PMCID: PMC6607565 DOI: 10.1177/2382120519859298] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Accepted: 05/31/2019] [Indexed: 06/10/2023]
Abstract
INTRODUCTION Outpatient procedures are an important component of primary care, yet few programs incorporate procedural training into their curriculum. We examined a 4-year procedural curriculum to improve understanding of ambulatory procedures and increase the number of procedures performed. METHODS A total of 56 resident and 8 faculty physicians participated in a procedural curriculum directed at joint injections (knee, shoulder, elbow, trochanteric bursa, carpal tunnel, wrist, and ankle), subdermal contraceptive insertion/removal, skin biopsies, and ultrasound use in primary care. We administered annual surveys and used generalized estimating equations to model changes. RESULTS Across the 4 years, there was an average 96% response rate. Mean comfort level with the indications for procedures increased for both resident (62.5 to 78.8; P < .0001) and faculty physicians (61.5 to 94.8; P < .0001). Similarly, mean comfort with performing procedures increased for both resident (32.1 to 62.3; P < .0001) and faculty physicians (42.2 to 85.4; P < .0001). Residents' comfort level performing procedures increased for all individual procedures measured. The mean number of procedures performed per year increased for resident (1.9 to 8.2; P < .0001) and faculty physicians (14.7 to 25.2; P = .087). CONCLUSIONS A longitudinal ambulatory-based procedural curriculum can increase resident and faculty physician understanding and comfort performing primary-care-based procedures. This, in turn, increased the total number of procedures performed.
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Affiliation(s)
- Robert J. Fortuna
- Department of Internal Medicine,
University of Rochester Medical Center, Rochester, NY, USA
- Department of Pediatrics,University of
Rochester Medical Center, Rochester, NY, USA
| | - Bethany Marston
- Department of Internal Medicine,
University of Rochester Medical Center, Rochester, NY, USA
- Department of Pediatrics,University of
Rochester Medical Center, Rochester, NY, USA
- Department of Internal Medicine,
Allergy/Immunology and Rheumatology, University of Rochester Medical Center,
Rochester, NY, USA
| | - Susan Messing
- Department of Biostatistics and
Computational Biology, University of Rochester Medical Center, Rochester, NY,
USA
| | - Gunnar Wagoner
- Department of Internal Medicine,
University of Rochester Medical Center, Rochester, NY, USA
- Department of Pediatrics,University of
Rochester Medical Center, Rochester, NY, USA
| | - Tiffany L. Pulcino
- Department of Internal Medicine,
University of Rochester Medical Center, Rochester, NY, USA
- Department of Pediatrics,University of
Rochester Medical Center, Rochester, NY, USA
| | - Todd Bingemann
- Department of Internal Medicine,
University of Rochester Medical Center, Rochester, NY, USA
- Department of Pediatrics,University of
Rochester Medical Center, Rochester, NY, USA
| | - Enrico Caiola
- Department of Internal Medicine,
University of Rochester Medical Center, Rochester, NY, USA
- Department of Pediatrics,University of
Rochester Medical Center, Rochester, NY, USA
| | - Steven Scofield
- Department of Internal Medicine,
University of Rochester Medical Center, Rochester, NY, USA
- Department of Pediatrics,University of
Rochester Medical Center, Rochester, NY, USA
| | - Karen Nead
- Department of Internal Medicine,
University of Rochester Medical Center, Rochester, NY, USA
- Department of Pediatrics,University of
Rochester Medical Center, Rochester, NY, USA
| | - Brett W Robbins
- Department of Internal Medicine,
University of Rochester Medical Center, Rochester, NY, USA
- Department of Pediatrics,University of
Rochester Medical Center, Rochester, NY, USA
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15
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Bravo‐Jaimes K, Samala V, Fernandez G, Moravan MJ, Dhakal S, Shah AH, Messing S, Singh K, Aktas MK. CIED malfunction in patients receiving radiation is a rare event that could be detected by remote monitoring. J Cardiovasc Electrophysiol 2018; 29:1268-1275. [DOI: 10.1111/jce.13659] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 05/24/2018] [Accepted: 05/30/2018] [Indexed: 12/15/2022]
Affiliation(s)
- Katia Bravo‐Jaimes
- Department of CardiologyUniversity of Texas Health Science Center at Houston Houston TX USA
| | - Vikram Samala
- Department of MedicineCheshire Medical and Dartmouth‐Hitchcock Keene Keene NH USA
| | - Genaro Fernandez
- Department of CardiologyUniversity of Minnesota Minneapolis MN USA
| | - Michael J. Moravan
- Department of Radiation OncologyUniversity of Rochester Medical Center Rochester NY USA
| | - Sughosh Dhakal
- Department of Radiation OncologyUniversity of Rochester Medical Center Rochester NY USA
| | - Abrar H. Shah
- Sands Constellation Heart InstituteRochester Regional Health Rochester NY USA
| | - Susan Messing
- Department of Biostatistics and Computational BiologyUniversity of Rochester Rochester NY USA
| | - Kyra Singh
- Department of Biostatistics and Computational BiologyUniversity of Rochester Rochester NY USA
| | - Mehmet K. Aktas
- Department of CardiologyUniversity of Rochester Medical Center Rochester NY USA
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16
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Welaya K, Messing S, Szuba E, Maggiore RJ. Geriatric assessment (GA) and treatment (Tx) outcomes in older adults with cancer receiving immunotherapy (IO). J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e22023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Karim Welaya
- Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY
| | - Susan Messing
- University of Rochester Medical Center, Rochester, NY
| | - Emily Szuba
- University of New England College of Osteopathic Medicine, Biddeford, ME
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17
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Walker RD, Messing S, Rosen-Carole C, McKenna Benoit M. Defining Tip-Frenulum Length for Ankyloglossia and Its Impact on Breastfeeding: A Prospective Cohort Study. Breastfeed Med 2018; 13:204-210. [PMID: 29620937 DOI: 10.1089/bfm.2017.0116] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The purpose of this study was to investigate the normal lingual frenulum anatomy in newborns and to evaluate tip-frenulum distance as an objective diagnostic tool for identifying newborns at risk for anterior and posterior tongue tie and breastfeeding difficulty. MATERIALS AND METHODS The distance from the tongue tip to the insertion of the lingual frenulum was measured in a group of 100 healthy newborns to establish normative data. The presence of a visible or palpable cord was noted. Inter-rater reliability was assessed. Breastfeeding surveys including a maternal pain scale and Infant Breastfeeding Assessment Tool (IBFAT) were administered on days of life 2 and 14 to determine whether these findings predict breastfeeding difficulty. RESULTS Mean tip-frenulum length was 9.07 mm. Intraclass correlation coefficient between observers for tip-frenulum length was 0.82. A visible cord was identified in 21 subjects (21%). A palpable cord was identified in 59 subjects (59%). Unweighted κ coefficients for inter-rater reliability of visible and palpable cords were 0.91 and 0.47, respectively. Visible cord and shorter tip-frenulum distance were independently predictive of higher maternal pain scores. A positive correlation was identified between tip-frenulum length and IBFAT scores for mothers with two or more previous breastfed children. CONCLUSIONS Tongue tip-frenulum length correlated with maternal nipple pain, and was useful as an objective tool for identifying newborns at risk for ankyloglossia. Maternal breastfeeding experience appears to be an important factor in the link between tongue anatomy and breastfeeding difficulty. The presence of a palpable cord was variable across examiners, and should be interpreted with caution when evaluating newborns for posterior tongue tie.
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Affiliation(s)
- Ryan D Walker
- 1 Department of Otolaryngology, University of Rochester , Rochester, New York
| | - Susan Messing
- 2 Department of Biostatistics and Computational Biology, University of Rochester , Rochester, New York
| | - Casey Rosen-Carole
- 3 Department of Pediatrics and Obstetrics and Gynecology, University of Rochester , Rochester, New York
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18
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Venuto CS, Lim J, Messing S, Hunt PW, McComsey GA, Morse GD. Inflammation investigated as a source of pharmacokinetic variability of atazanavir in AIDS Clinical Trials Group protocol A5224s. Antivir Ther 2018; 23:345-351. [PMID: 29171837 PMCID: PMC5967996 DOI: 10.3851/imp3209] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2017] [Indexed: 12/26/2022]
Abstract
BACKGROUND Inflammation is associated with the downregulation of drug metabolizing enzymes and transporters. Thus, we investigated the chronic inflammatory state associated with HIV infection as a source of pharmacokinetic variability of atazanavir. We also explored the association of total bilirubin concentrations with markers of inflammation and endothelial activation. METHODS Apparent oral clearance (CL/F) of atazanavir was estimated from plasma samples collected from participants in AIDS Clinical Trials Group Study A5202. Several inflammatory and endothelial activation biomarkers were measured at baseline and weeks 24 and 96 as part of metabolic substudy A5224s: high-sensitivity C-reactive protein (hsCRP), interleukin-6, tumour necrosis factor-α and its soluble receptors, soluble vascular cellular and intracellular adhesion molecules and total bilirubin. Statistical analysis was performed by a matrix of correlation coefficients between atazanavir CL/F and biomarker concentrations measured at week 24. The correlation between atazanavir clearance and percentage change in bilirubin from baseline to weeks 24 and 96, and between biomarkers and bilirubin concentrations at each week were also evaluated. RESULTS Among 107 participants, there were no significant correlations observed between atazanavir CL/F and inflammatory and endothelial activation biomarkers measured at week 24 (P≥0.24). As expected, bilirubin increased with increasing exposure to atazanavir (rho=-0.25, P=0.01). Bilirubin concentrations were inversely correlated (P<0.01) with each of the biomarkers except hsCRP. CONCLUSIONS Atazanavir CL/F did not correlate with the inflammatory biomarkers changes. Inflammatory-mediated inhibition of cytochrome P450 3A may have been attenuated due to atazanavir-associated increases of bilirubin, which has known anti-inflammatory properties.
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Affiliation(s)
- Charles S Venuto
- Center for Human Experimental Therapeutics, Adult HIV Therapeutic Strategies Network CRS, University of Rochester, Rochester, NY, USA
- AIDS Clinical Trials Group Pharmacology Specialty Laboratory, New York State Center of Excellence in Bioinformatics and Life Sciences, School of Pharmacy and Pharmaceutical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Jihoon Lim
- Center for Human Experimental Therapeutics, Adult HIV Therapeutic Strategies Network CRS, University of Rochester, Rochester, NY, USA
| | - Susan Messing
- Department of Biostatistics and Computational Biology, University of Rochester, Rochester, NY, USA
| | - Peter W Hunt
- Division of Experimental Medicine, Department of Medicine, University of California, San Francisco, CA, USA
| | - Grace A McComsey
- Case Western Reserve University and University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Gene D Morse
- AIDS Clinical Trials Group Pharmacology Specialty Laboratory, New York State Center of Excellence in Bioinformatics and Life Sciences, School of Pharmacy and Pharmaceutical Sciences, University at Buffalo, Buffalo, NY, USA
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19
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Schultze M, Frahsa A, Gelius P, Schätzlein V, Messing S, Rütten A. Transdisziplinäre Aushandlungsprozesse unter WissenschaftlerInnen im Forschungsverbund „Capital4Health – Capabilites for active lifestyles“. Das Gesundheitswesen 2017. [DOI: 10.1055/s-0037-1605780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- M Schultze
- Universität Erlangen-Nürnberg, Institut für Sport und Sportwissenschaft, Erlangen
| | - A Frahsa
- Universität Erlangen-Nürnberg, Institut für Sport und Sportwissenschaft, Erlangen
| | - P Gelius
- Universität Erlangen-Nürnberg, Institut für Sport und Sportwissenschaft, Erlangen
| | - V Schätzlein
- Universität Erlangen-Nürnberg, Institut für Sport und Sportwissenschaft, Erlangen
| | - S Messing
- Universität Erlangen-Nürnberg, Institut für Sport und Sportwissenschaft, Erlangen
| | - A Rütten
- Universität Erlangen-Nürnberg, Institut für Sport und Sportwissenschaft, Erlangen
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20
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Abstract
BACKGROUND Although surgery can provide definitive treatment for de Quervain's tenosynovitis, nonoperative treatment could be preferable if symptoms are predictably relieved. We sought to determine the effectiveness of corticosteroid injections as treatment for de Quervain's tenosynovitis and to evaluate patient characteristics as predictors of treatment outcome. METHODS A retrospective study was conducted using our institutional database International Classification of Disease, version 9 (ICD-9) code list for de Quervain's tenosynovitis. Treatment success was defined as relief of symptoms after 1 or 2 injections. Relief was defined as resolution or improvement to the extent that the patient did not seek further intervention. Failure was defined as a subsequent surgical release or a third injection. Logistic regression analyses were performed to look for univariate associations between patient demographics/comorbidities and risk of treatment failure. RESULTS The treatment outcome of 222 limbs from 199 patients was studied. Of the 222 limbs, 73.4% (95% confidence interval [CI], 66.9%-79.1%) experienced treatment success within 2 injections, and 51.8% (95% CI, 45.0%-58.6%) experienced success after 1 injection. Body mass index (BMI) >30 and female sex were found to be significantly associated with treatment failure, with a 2.4-fold increase (95% CI, 1.02%-5.72%) in odds and 3.23 times greater (95% CI, 1.08%-9.67%) odds of failure, respectively. Although not reaching statistical significance, African American race, hypothyroidism, and carpal tunnel syndrome suggested increased odds of failure. CONCLUSIONS This study indicates that corticosteroid injections are a useful treatment for de Quervain's tenosynovitis, leading to treatment success 73.4% of the time within 2 injections. This study also suggests that female sex and BMI >30 are associated with increased treatment failure.
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Affiliation(s)
| | | | | | - Warren C. Hammert
- University of Rochester, NY, USA,Warren C. Hammert, Chief, Division of Hand Surgery, Department of Orthopaedics and Rehabilitation, University of Rochester Medical Center, 601 Elmwood Ave, Box 665, Rochester, NY 14642, USA.
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21
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Chen W, Melamed ML, Hostetter TH, Bauer C, Raff AC, Almudevar AL, Lalonde A, Messing S, Abramowitz MK. Effect of oral sodium bicarbonate on fibroblast growth factor-23 in patients with chronic kidney disease: a pilot study. BMC Nephrol 2016; 17:114. [PMID: 27495287 PMCID: PMC4974735 DOI: 10.1186/s12882-016-0331-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Accepted: 08/02/2016] [Indexed: 12/16/2022] Open
Abstract
Background The regulation of fibroblast growth factor-23 (FGF23) secretion in patients with chronic kidney disease (CKD) is incompletely understood. An in vitro study showed that metabolic acidosis increased FGF23 in mouse bone. The objective of this study is to evaluate the effect of oral sodium bicarbonate on circulating FGF23 levels in patients with CKD. Methods This was a single-blind pilot study. Twenty adults with estimated glomerular filtration rate between 15–45 mL/min/1.73 m2 and serum bicarbonate between 20–24 mEq/L were treated with placebo for 2 weeks, followed by increasing doses of oral sodium bicarbonate (0.3, 0.6 and 1.0 mEq/kg/day) in 2 week intervals for a total of 6 weeks. C-terminal FGF23 levels were measured at the initial visit, after 2 weeks of placebo and after 6 weeks of bicarbonate therapy. Wilcoxon matched-pairs signed-rank test was used to compare FGF23 before and after sodium bicarbonate. Results After 6 weeks of oral sodium bicarbonate, the median FGF23 increased significantly from 150.9 RU/mL (IQR 107.7–267.43) to 191.4 RU/mL (IQR 132.6–316.9) (p = 0.048) and this persisted after excluding participants who received activated vitamin D. Conclusions FGF23 increased after short-term oral sodium bicarbonate therapy in patients with CKD and mild metabolic acidosis. It is unclear whether this was due to the alkalinizing effect of sodium bicarbonate or other factors. Trial registration The study was registered at ClinicalTrials.gov (NCT00888290) on April 23, 2009.
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Affiliation(s)
- Wei Chen
- Department of Medicine, University of Rochester School of Medicine and Dentistry, 601 Elmwood Avenue, Box 675, Rochester, NY, 14642, USA.
| | - Michal L Melamed
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA.,Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Thomas H Hostetter
- Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Carolyn Bauer
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Amanda C Raff
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Anthony L Almudevar
- Department of Biostatistics & Computation Biology, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - Amy Lalonde
- Department of Biostatistics & Computation Biology, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - Susan Messing
- Department of Biostatistics & Computation Biology, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - Matthew K Abramowitz
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA.,Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
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Gonzalez RS, Messing S, Tu X, McMahon LA, Whitney-Miller CL. Immunohistochemistry as a surrogate for molecular subtyping of gastric adenocarcinoma. Hum Pathol 2016; 56:16-21. [PMID: 27342907 DOI: 10.1016/j.humpath.2016.06.003] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Revised: 05/26/2016] [Accepted: 06/11/2016] [Indexed: 12/16/2022]
Abstract
The Cancer Genome Atlas Research Network recently classified gastric adenocarcinoma into 4 molecular subtypes: Epstein-Barr virus-positive tumors, microsatellite-unstable tumors, tumors with chromosomal instability, and genomically stable tumors. We theorized that immunohistochemistry might be useful in similar categorization and that that HER2 expression might relate to subtype. We stained 104 gastric adenocarcinomas for MLH1, p53, and EBER in situ hybridization. We grouped them based on staining pattern and compared the groups. Cases were categorized as follows: group 1 (EBER positive), 7 cases (7%); group 2 (MLH1 deficient), 17 cases (16%); group 3 (aberrant p53 staining, EBER negative, retained MLH1), 40 cases (38%); group 4 (unremarkable staining), 40 cases (38%). This distribution was comparable to that found by the Research Network after accounting for the TP53 mutation rate in the chromosomal instability group. Group 1 patients had significantly longer follow-up times (median, 70 months versus 13 months for other groups; P = .0324). No group 2 cases overexpressed HER2. In group 3, 3 of 40 cases were HER2 immunohistochemistry positive, but 7 of 27 were HER2 positive by fluorescence in situ hybridization. Staining offers an efficient, reasonably accurate alternative for molecular subtyping of gastric adenocarcinoma, although some cases with chromosomal instability cannot be identified. These findings have potential prognostic and therapeutic implications.
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Affiliation(s)
- Raul S Gonzalez
- Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, NY 14642.
| | - Susan Messing
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY 14642
| | - Xin Tu
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY 14642
| | - Loralee A McMahon
- Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, NY 14642
| | - Christa L Whitney-Miller
- Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, NY 14642
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23
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Felsen C, Quinlan G, El-Daher N, Farnsworth D, Graman P, Greene L, Laguio M, Shelly M, Pettis AM, Tang W, Tu X, Messing S, Ashley ED, Dumyati G. City-Wide Collaboration to Reduce Clostridium difficile Infections. Open Forum Infect Dis 2015. [DOI: 10.1093/ofid/ofv133.685] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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24
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Canham CD, Schreck MJ, Maqsoodi N, Messing S, Olles M, Elfar JC. Distal Radioulnar Joint Reaction Force Following Ulnar Shortening: Diaphyseal Osteotomy Versus Wafer Resection. J Hand Surg Am 2015; 40:2206-12. [PMID: 26452758 PMCID: PMC5828165 DOI: 10.1016/j.jhsa.2015.07.036] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2014] [Revised: 07/08/2015] [Accepted: 07/08/2015] [Indexed: 02/02/2023]
Abstract
PURPOSE To compare how ulnar diaphyseal shortening and wafer resection affect distal radioulnar joint (DRUJ) joint reaction force (JRF) using a nondestructive method of measurement. Our hypothesis was that ulnar shortening osteotomy would increase DRUJ JRF more than wafer resection. METHODS Eight fresh-frozen human cadaveric upper limbs were obtained. Under fluoroscopic guidance, a threaded pin was inserted into the lateral radius orthogonal to the DRUJ and a second pin was placed in the medial ulna coaxial to the radial pin. Each limb was mounted onto a mechanical tensile testing machine and a distracting force was applied across the DRUJ while force and displacement were simultaneously measured. Data sets were entered into a computer and a polynomial was generated and solved to determine the JRF. This process was repeated after ulnar diaphyseal osteotomy, ulnar re-lengthening, and ulnar wafer resection. The JRF was compared among the 4 conditions. RESULTS Average baseline DRUJ JRF for the 8 arms increased significantly after diaphyseal ulnar shortening osteotomy (7.2 vs 10.3 N). Average JRF after re-lengthening the ulna and wafer resection was 6.9 and 6.7 N, respectively. There were no differences in JRF among baseline, re-lengthened, and wafer resection conditions. CONCLUSIONS Distal radioulnar joint JRF increased significantly after ulnar diaphyseal shortening osteotomy and did not increase after ulnar wafer resection. CLINICAL RELEVANCE Diaphyseal ulnar shortening osteotomy increases DRUJ JRF, which may lead to DRUJ arthrosis.
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Affiliation(s)
- Colin D. Canham
- Department of Orthopaedic Surgery, University of Rochester, Rochester, NY,Rochester Institute of Technology/University of Rochester Orthopaedic Biomechanics Laboratory, Rochester, NY
| | - Michael J. Schreck
- Department of Orthopaedic Surgery, University of Rochester, Rochester, NY,Rochester Institute of Technology/University of Rochester Orthopaedic Biomechanics Laboratory, Rochester, NY
| | - Noorullah Maqsoodi
- Rochester Institute of Technology/University of Rochester Orthopaedic Biomechanics Laboratory, Rochester, NY,Department of Manufacturing and Mechanical Engineering Technology, Rochester Institute of Technology, Rochester, NY
| | - Susan Messing
- Department of Biostatistics and Computational Biology, University of Rochester, Rochester, NY
| | - Mark Olles
- Rochester Institute of Technology/University of Rochester Orthopaedic Biomechanics Laboratory, Rochester, NY,Department of Manufacturing and Mechanical Engineering Technology, Rochester Institute of Technology, Rochester, NY
| | - John C. Elfar
- Department of Orthopaedic Surgery, University of Rochester, Rochester, NY,Rochester Institute of Technology/University of Rochester Orthopaedic Biomechanics Laboratory, Rochester, NY
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25
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Yaseen Z, English C, Stanbury SJ, Chen T, Messing S, Awad H, Elfar JC. The Effect of the Epitendinous Suture on Gliding in a Cadaveric Model of Zone II Flexor Tendon Repair. J Hand Surg Am 2015; 40:1363-8. [PMID: 25920620 PMCID: PMC5837028 DOI: 10.1016/j.jhsa.2015.03.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Revised: 03/06/2015] [Accepted: 03/07/2015] [Indexed: 02/02/2023]
Abstract
PURPOSE We hypothesized that increasing core sutures (4-6) may be preferable in terms of gliding coefficient (GC) measurements when compared with adding an epitendinous suture to zone II flexor tendon repairs. We hypothesized that the inclusion of epitendinous suture in 2 standard repairs would contribute negatively to the GC of the repaired tendon. METHODS Nineteen fresh-frozen cadaveric fingers were used for testing. We compared a control group (dissected digits without repair) and 4-strand or 6-strand core tendon repairs with and without epitendinous suture. Arc of motion was driven by direct loading, and digital images were acquired and analyzed. Outcomes were defined as the difference in GC between the native uninjured and the repaired state at each load. A linear mixed-model analysis was performed with comparisons between repairs to evaluate the statistically relevant differences between groups. RESULTS The test of fixed effects in the linear model revealed that repair type and the use of epitendinous suture significantly affected the change in GC. The addition of an epitendinous suture produced a significant decrement in gliding regardless of repair type. CONCLUSIONS There was significant improvement in GC with the omission of the epitendinous suture in both repair types (4- or 6-strand). CLINICAL RELEVANCE The epitendinous suture used in this model resulted in poorer gliding of the repair, which may correspond with an expected increase in catching or triggering.
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Affiliation(s)
- Zaneb Yaseen
- Department of Orthopaedic Surgery, Division of Hand and Shoulder and Elbow Surgery, University of Rochester, Rochester, NY
| | - Christopher English
- Department of Orthopaedic Surgery, Division of Hand and Shoulder and Elbow Surgery, University of Rochester, Rochester, NY
| | - Spencer J. Stanbury
- Department of Orthopaedic Surgery, Division of Hand and Shoulder and Elbow Surgery, University of Rochester, Rochester, NY
| | - Tony Chen
- Department of Orthopaedic Surgery, Division of Hand and Shoulder and Elbow Surgery, University of Rochester, Rochester, NY
| | - Susan Messing
- Department of Orthopaedic Surgery, Division of Hand and Shoulder and Elbow Surgery, University of Rochester, Rochester, NY
| | - Hani Awad
- Department of Orthopaedic Surgery, Division of Hand and Shoulder and Elbow Surgery, University of Rochester, Rochester, NY
| | - John C. Elfar
- Department of Orthopaedic Surgery, Division of Hand and Shoulder and Elbow Surgery, University of Rochester, Rochester, NY
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26
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Stoner MC, Seaman MJ, Doyle A, Rasheed K, Messing S. SS4. Evaluating the Value of AAA Repair Through Anatomic Severity Grade. J Vasc Surg 2015. [DOI: 10.1016/j.jvs.2015.04.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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27
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Bakshy E, Messing S, Adamic LA. Exposure to ideologically diverse news and opinion on Facebook. Science 2015; 348:1130-2. [DOI: 10.1126/science.aaa1160] [Citation(s) in RCA: 1174] [Impact Index Per Article: 130.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Accepted: 04/27/2015] [Indexed: 11/02/2022]
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28
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Elnagdy S, Messing S, Majerus MEN. The Japanese ladybirds, Coccinula crotchi and Coccinula sinensis, are infected with very closely related strains of male-killing Flavobacterium. Insect Sci 2014; 21:699-706. [PMID: 24124002 DOI: 10.1111/1744-7917.12062] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/20/2013] [Indexed: 06/02/2023]
Abstract
Male-killing is 1 of 4 known strategies that inherited parasitic endosymbionts have evolved to manipulate their host's reproduction. In early male-killing, infected male offspring are killed early in embryogenesis. Within the Insecta, male-killing bacteria have been found in a wide range of hosts. The Coccinellidae families of beetles, better known as ladybirds, are particularly prone to male-killer invasion. In samples of the coccinellid, Coccinula crotchi, from Japan, a new male-killing bacterium was revealed by phenotypic assay. Molecular genetic analysis revealed the identity to be a tetracycline-sensitive Flavobacterium that causes female-biased offspring sex ratio. Furthermore, that Flavobacterium strain was found to be closely related to the Flavobacterium causing male-killing in the congeneric Japanese coccinellid, Coccinula sinensis, which was collected from the same region. However, we found slightly different Flavobacterium strains infecting C. sinensis from regions with different environmental conditions. This may be an indication of horizontal transmission of male-killing Flavobacterium between these 2 ladybird spices. Finally, environmental conditions may affect the spread of male-killing bacteria among their hosts.
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Affiliation(s)
- Sherif Elnagdy
- Department of Genetics, University of Cambridge, Downing Street, Cambridge, CB2 3EH, UK; Botany Department, Faculty of Science, Cairo University, Giza, Egypt
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Vitek WS, Shayne M, Hoeger K, Han Y, Messing S, Fung C. Gonadotropin-releasing hormone agonists for the preservation of ovarian function among women with breast cancer who did not use tamoxifen after chemotherapy: a systematic review and meta-analysis. Fertil Steril 2014; 102:808-815.e1. [PMID: 25044080 DOI: 10.1016/j.fertnstert.2014.06.003] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Revised: 06/02/2014] [Accepted: 06/02/2014] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To determine whether concurrent use of GnRH agonists with chemotherapy preserves ovarian function in women with breast cancer who did not use tamoxifen. DESIGN Systematic review and meta-analysis. SETTING University-based hospitals. PATIENT(S) Premenopausal women with breast cancer treated with chemotherapy who did not receive tamoxifen. INTERVENTION(S) Randomization to concurrent GnRH agonists with chemotherapy or chemotherapy alone. MAIN OUTCOME MEASURE(S) Odds ratio (OR) of resumption of menses 1 year or more after chemotherapy. RESULT(S) Searches were conducted in PubMed, Scopus, Cochrane Trials Register, and the National Research Register through March 2014, and all randomized trials that reported resumption of menses 1 year or more after GnRH agonist with chemotherapy or chemotherapy alone among women with breast cancer who did not receive tamoxifen were included. Four studies were analyzed in the meta-analysis and included 252 patients (GnRH agonist with chemotherapy, n=131; chemotherapy alone, n=121). There was no significant difference in the rate of return of menses between the two groups (OR, 1.47; 95% confidence interval [0.60-3.62]). Heterogeneity among the trials was not significant (I2=16.6%). CONCLUSION(S) Concurrent GnRH agonists with chemotherapy may not preserve ovarian function in women with breast cancer. Furthermore, randomized data are limited regarding fertility after concurrent use of GnRH agonists with chemotherapy.
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Affiliation(s)
- Wendy S Vitek
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Rochester School of Medicine and Dentistry, Rochester, New York.
| | - Michelle Shayne
- Department of Hematology and Oncology, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Kathleen Hoeger
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Yu Han
- Department of Biostatistics and Computational Biology, University of Rochester, Rochester, New York
| | - Susan Messing
- Department of Biostatistics and Computational Biology, University of Rochester, Rochester, New York
| | - Chunkit Fung
- Department of Hematology and Oncology, University of Rochester School of Medicine and Dentistry, Rochester, New York
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30
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Knight JM, Moynihan JA, Lyness JM, Xia Y, Tu X, Messing S, Hunter BC, Huang LS, Obi RO, Gaisser D, Liesveld JL, Sahler OJZ. Peri-transplant psychosocial factors and neutrophil recovery following hematopoietic stem cell transplantation. PLoS One 2014; 9:e99778. [PMID: 24915544 PMCID: PMC4051840 DOI: 10.1371/journal.pone.0099778] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2014] [Accepted: 05/19/2014] [Indexed: 12/21/2022] Open
Abstract
Objective Multiple psychosocial factors appear to affect cancer progression in various populations; however, research investigating the relationship between psychosocial factors and outcomes following hematopoietic stem cell transplantation (HCT) is scarce. Subject to adverse immunological and psychological conditions, HCT patients may be especially vulnerable to psychosomatic health sequelae; therefore, we studied whether optimism and anxiety influence the pertinent clinical outcome of days to neutrophil engraftment (DTE). Method 54 adults undergoing either autologous or allogeneic HCT completed self-report questionnaires measuring optimism and anxiety. We assessed the association between these psychosocial variables and DTE. Results Greater optimism and less anxiety were associated with the favorable outcome of fewer DTE in autologous HCT recipients, though this relationship was no longer significant when reducing the sample size to only subjects who filled out their baseline survey by the time of engraftment. Conclusion Our findings are suggestive that optimism and anxiety may be associated with time to neutrophil recovery in autologous, but not allogeneic, adult HCT recipients. Further investigation in larger, more homogeneous subjects with consistent baseline sampling is warranted.
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Affiliation(s)
- Jennifer M. Knight
- University of Rochester Medical Center, Department of Psychiatry, the Rochester Center for Mind-Body Research, Rochester, New York, United States of America
- * E-mail:
| | - Jan A. Moynihan
- University of Rochester Medical Center, Department of Psychiatry, the Rochester Center for Mind-Body Research, Rochester, New York, United States of America
| | - Jeffrey M. Lyness
- University of Rochester Medical Center, Department of Psychiatry, the Rochester Center for Mind-Body Research, Rochester, New York, United States of America
| | - Yinglin Xia
- University of Rochester Medical Center, Department of Biostatistics and Computational Biology, Rochester, New York, United States of America
| | - Xin Tu
- University of Rochester Medical Center, Department of Biostatistics and Computational Biology, Rochester, New York, United States of America
| | - Susan Messing
- University of Rochester Medical Center, Department of Biostatistics and Computational Biology, Rochester, New York, United States of America
| | - Bryan C. Hunter
- Nazareth College, Department of Music Therapy, Rochester, New York, United States of America
| | - Li-Shan Huang
- University of Rochester Medical Center, Department of Biostatistics and Computational Biology, Rochester, New York, United States of America
| | - Rosemary O. Obi
- University of Rochester Medical Center, Department of Pediatrics, Division of Hematology/Oncology, Rochester, New York, United States of America
| | - D'Arcy Gaisser
- University of Rochester Medical Center, Department of Cardiology, Rochester, New York, United States of America
| | - Jane L. Liesveld
- University of Rochester Medical Center, Department of Medicine, Division of Hematology/Oncology, Rochester, New York, United States of America
| | - Olle Jane Z. Sahler
- University of Rochester Medical Center, Department of Pediatrics, Division of Hematology/Oncology, Rochester, New York, United States of America
- University of Rochester Medical Center, Department of Medicine, Division of Hematology/Oncology, Rochester, New York, United States of America
- University of Rochester Medical Center, Department of Psychiatry, Rochester, New York, United States of America
- University of Rochester Medical Center, Department of Medical Humanities, Rochester, New York, United States of America
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Sherman M, Tsynman DN, Kim A, Arora J, Pietras T, Messing S, St Hilaire L, Yoon S, Decross A, Shah A, Saubermann L. Sustained improvement in health-related quality of life measures in patients with inflammatory bowel disease receiving prolonged anti-tumor necrosis factor therapy. J Dig Dis 2014; 15:174-9. [PMID: 24373601 DOI: 10.1111/1751-2980.12125] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE The aim of this study was to determine whether the effects of prolonged therapy (≥1 year) with anti-tumor necrosis factor (TNF) agents were sustained on the health-related quality of life (HRQoL) in patients with inflammatory bowel disease (IBD). METHODS A cross-sectional survey of patients with IBD who were treated with anti-TNF agents was performed. Results of the validated HRQoL measures (inflammatory bowel disease questionnaire [IBDQ], EuroQoL-5 dimensions [EQ-5D], health status visual analogue scale [VAS] and the Zung self-rating depression scale) were recorded and compared between patients treated with anti-TNF agents for <1 year and ≥1 year. RESULTS A total of 41 patients were finally enrolled in the study. Among them, 11 (26.8%) had received anti-TNF therapy for less than one year with a median duration of 7 months (range 3-11 months), while the other 30 (73.2%) had been treated for ≥1 year with a median duration of 42 months (range 12-104 months). Crohn's disease was the most common type in both groups. None of the mean IBDQ, EQ-5D and EQ-5D plus VAS, or Zung self-rating depression scale scores differed significantly between the two groups of patients. CONCLUSIONS Improvements in HRQoL for IBD patients on anti-TNF therapy were sustained for longer than one year. HRQoL measures for IBD patients treated with anti-TNF therapy for <1 year do not differ significantly from those treated for ≥1 year, but a trend towards improved HRQoL measures with prolonged therapy can be obtained.
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Affiliation(s)
- Michael Sherman
- Department of Internal Medicine, San Antonio Uniformed Services Health Education Consortium, San Antonio, Texas, USA
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32
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Langfitt JT, Vickrey BG, McDermott MP, Messing S, Berg AT, Spencer SS, Sperling MR, Bazil CW, Shinnar S. Validity and Responsiveness of Generic Preference-based HRQOL Instruments in Chronic Epilepsy. Qual Life Res 2013; 15:899-914. [PMID: 16721649 DOI: 10.1007/s11136-005-5231-3] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2005] [Indexed: 11/30/2022]
Abstract
Generic, preference-based instruments are recommended for assessing health-related quality of life (HRQOL) in cost-utility analyses (CUA). We aimed to determine which instrument is the most appropriate for CUA of epilepsy care, using established psychometric criteria. We compared validity and responsiveness of EQ5D (using both UK and US preferences), visual analog scale (VAS), Health Utilities Index Mark II (HUI-2) and Mark III (HUI-3) and SF6D in 165 adults evaluated for epilepsy surgery. SF6D had the strongest or next-strongest associations with seizure severity and seizure control. It was not associated with education or IQ. Only SF6D and HUI-3 discriminated between patients with and without seizures 2 years after baseline evaluation. SF6D was most or next-most responsive to being seizure-free for 2 years, in most responsiveness analyses. VAS was also responsive, but showed less evidence of validity. The QOLIE-89, an epilepsy-targeted profile instrument, had stronger evidence for validity and responsiveness than the preference instruments. SF6D has several key psychometric advantages over four other preference instruments in CUAs of epilepsy care. This may reflect better coverage of HRQOL dimensions affected by epilepsy, greater sensitivity at the upper end of the HRQOL continuum, or both. These findings may not generalize to other chronic conditions.
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Affiliation(s)
- J T Langfitt
- Department of Neurology & Psychiatry, University of Rochester School of Medicine, 601 Elmwood Ave, Box 673, Rochester, NY 14642, USA
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Vitek W, Hoeger K, Han Y, Messing S, Shayne M, Fung C. Systematic review and meta-analysis of GnRH agonist for preservation of ovarian function in women with hormone receptor negative breast cancer after chemotherapy. Fertil Steril 2013. [DOI: 10.1016/j.fertnstert.2013.07.1651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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34
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Pala O, Messing S, Hopkins A, Reed G, Perez-Rivera M, Acosta M, Kremer J, Lozada C, Pappas D. FRI0170 Effect of alcohol on response to therapy with TNF-a inhibitors for rheumatoid arthritis: Results from corrona registry. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.2627] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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35
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Pala O, Messing S, Hopkins A, Reed G, Perez-Rivera M, Acosta M, Kremer J, Lozada C, Pappas D. SAT0147 Effect of smoking on response to therapy with TNF-A inhibitors for rheumatoid arthritis: Results from the corrona registry. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.3094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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36
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Jawaheer D, Messing S, Reed G, Ranganath VK, Kremer JM, Louie JS, Khanna D, Greenberg JD, Furst DE. Significance of sex in achieving sustained remission in the consortium of rheumatology researchers of North America cohort of rheumatoid arthritis patients. Arthritis Care Res (Hoboken) 2013; 64:1811-8. [PMID: 22730408 DOI: 10.1002/acr.21762] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2011] [Accepted: 06/07/2012] [Indexed: 01/29/2023]
Abstract
OBJECTIVE To determine whether men with rheumatoid arthritis (RA) are more likely to achieve remission compared to women. METHODS RA patients enrolled in the Consortium of Rheumatology Researchers of North America (CORRONA) cohort between October 2001 and January 2010 were selected for the present analyses. Detailed clinical, demographic, and drug utilization data were available at enrollment (baseline) and at subsequent followup visits. We examined the influence of sex on the Clinical Disease Activity Index remission score (≤2.8) using sustained remission or point remission as the primary outcome measure in multivariate stepwise logistic regression models. We stratified the data by RA duration at baseline (≤2 years or >2 years) to investigate whether RA duration had differential effects on remission in men and women. RESULTS A total of 10,299 RA patients (2,406 men and 7,893 women) were available for this study. In both early and established RA, women had more severe disease at baseline with worse disease activity measures, modified Health Assessment Questionnaire disability index score, pain on a visual analog scale, and depression. Women were also more likely to have been treated with disease-modifying antirheumatic drugs and anti-tumor necrosis factor therapy compared to men. In the regression models, male sex was associated with sustained remission in early RA (odds ratio [OR] 1.38, 95% confidence interval [95% CI] 1.07-1.78, P = 0.01), but not in established RA. However, for point remission, an inverse association was observed with male sex in established RA (OR 0.65, 95% CI 0.48-0.87, P = 0.005) and not in early RA. CONCLUSION Within the large real-life CORRONA cohort of RA patients, men were more likely to achieve sustained remission compared to women in early RA, although not in established RA.
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Affiliation(s)
- Damini Jawaheer
- Children's Hospital Oakland Research Institute, Oakland, California, USA
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37
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Elnagdy S, Messing S, Majerus MEN. Two strains of male-killing Wolbachia in a ladybird, Coccinella undecimpunctata, from a hot climate. PLoS One 2013; 8:e54218. [PMID: 23349831 PMCID: PMC3549926 DOI: 10.1371/journal.pone.0054218] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2012] [Accepted: 12/10/2012] [Indexed: 11/19/2022] Open
Abstract
Ladybirds are a hot-spot for the invasion of male-killing bacteria. These maternally inherited endosymbionts cause the death of male host embryos, to the benefit of female sibling hosts and the bacteria that they contain. Previous studies have shown that high temperatures can eradicate male-killers from ladybirds, leaving the host free from infection. Here we report the discovery of two maternally inherited sex ratio distorters in populations of a coccinellid, Coccinella undecimpunctata, from a hot lowland region of the Middle East. DNA sequence analysis indicates that the male killing is the result of infection by Wolbachia, that the trait is tetracycline sensitive, and that two distinct strains of Wolbachia co-occur within one beetle population. We discuss the implications of these findings for theories of male-killing and suggest avenues for future field-work on this system.
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Affiliation(s)
- Sherif Elnagdy
- Department of Genetics, University of Cambridge, Cambridge, United Kingdom.
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Wills AMA, Eberly S, Tennis M, Lang AE, Messing S, Togasaki D, Tanner CM, Kamp C, Chen JF, Oakes D, McDermott MP, Schwarzschild MA. Caffeine consumption and risk of dyskinesia in CALM-PD. Mov Disord 2013; 28:380-3. [PMID: 23339054 DOI: 10.1002/mds.25319] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2012] [Revised: 10/24/2012] [Accepted: 11/12/2012] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Adenosine A2A receptor antagonists reduce or prevent the development of dyskinesia in animal models of levodopa-induced dyskinesia. METHODS We examined the association between self-reported intake of the A2A receptor antagonist caffeine and time to dyskinesia in the Comparison of the Agonist Pramipexole with Levodopa on Motor Complications of Parkinson's Disease (CALM-PD) and CALM Cohort extension studies, using a Cox proportional hazards model adjusting for age, baseline Parkinson's severity, site, and initial treatment with pramipexole or levodopa. RESULTS For subjects who consumed >12 ounces of coffee/day, the adjusted hazard ratio for the development of dyskinesia was 0.61 (95% CI, 0.37-1.01) compared with subjects who consumed <4 ounces/day. For subjects who consumed between 4 and 12 ounces/day, the adjusted hazard ratio was 0.73 (95% CI, 0.46-1.15; test for trend, P = .05). CONCLUSIONS These results support the possibility that caffeine may reduce the likelihood of developing dyskinesia.
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Affiliation(s)
- Anne-Marie A Wills
- Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA
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Yang Z, Li W, Tu X, Tang W, Messing S, Duan L, Pan J, Li X, Wan C. Validation and psychometric properties of Chinese version of SF-36 in patients with hypertension, coronary heart diseases, chronic gastritis and peptic ulcer. Int J Clin Pract 2012; 66:991-8. [PMID: 22994333 DOI: 10.1111/j.1742-1241.2012.02962.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND The SF-36 is widely used as a significant health outcome or quality of life indicator and validated in many languages versions including Chinese. But the Chinese version of the SF-36 (CSF-36) is rarely used for those patients with hypertension, coronary heart diseases, chronic gastritis and peptic ulcer in China. Therefore, the CSF-36 needs to be validated in patients with chronic diseases. OBJECTIVES This paper is aimed to validate the CSF-36 using an in-patient sample of four chronic diseases from mainland China, with focusing on psychometric properties. METHODS The CSF-36 was used in a longitudinal study consisting of 534 patients in these four chronic disease groups. The psychometric properties of the scale were evaluated by indicators such as validity and reliability coefficients Cronbach α, Pearson r, standardized response mean employing correlational analyses, multi-trait scaling analysis, t-tests, factor analyses and structural equation models. RESULTS Test-retest reliability coefficients for all domains were higher than 0.80 with a range of 0.83 to 0.96; the internal consistency (α) for most domains was higher than 0.70. Five of the eight domains as well as the Physical and Mental Health subscale summaries all had statistically significant changes after treatment with the SRM ranging from 0.18 to 0.28. CONCLUSION The CSF-36 showed good validity and reliability but small responsiveness when used in patients. It is a good and useful instrument for patients with chronic disease at some situations.
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Affiliation(s)
- Z Yang
- School of Public Health, Guangdong Medical College, Dongguan, China
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40
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Lee Y, Fleming FJ, Deeb AP, Gunzler D, Messing S, Monson JRT. A laparoscopic approach reduces short-term complications and length of stay following ileocolic resection in Crohn's disease: an analysis of outcomes from the NSQIP database. Colorectal Dis 2012; 14:572-7. [PMID: 21831174 DOI: 10.1111/j.1463-1318.2011.02756.x] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
AIM Studies to date examining the impact of laparoscopy in resection for Crohn's disease on short-term morbidity have been limited by small study populations. The aim of this study was to establish the impact of the operative approach (laparoscopic or open) on outcomes after ileocolic resection for Crohn's disease. METHOD Ileocolic resections for Crohn's disease were identified using Current Procedural Terminology (CPT) and International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) codes from the National Surgical Quality Improvement Program (NSQIP) database (2005-2009). Complications were categorized as major (organ system damage and systemic sepsis) or minor (incisional and urinary infections). Multivariate 30-day outcomes and length of stay were determined using linear models adjusting for patient characteristics, comorbidities and operative approach. RESULTS Of 1917 ileocolic resections, 644 (34%) were performed laparoscopically. At baseline, the open group was significantly older, had more comorbidities, higher American Society of Anesthesiology (ASA) classes, and more intra-operative transfusions (all variables, P<0.05). On multivariate analysis, laparoscopic ileocolic resections were associated with a decrease in major (OR=0.629, 95% CI: 0.430-0.905, P=0.014) and minor (OR=0.576, 95% CI: 0.405-0.804, P=0.002) complications compared with open resections. Laparoscopy was associated with a significant reduction in adjusted length of stay compared with the open approach (-1.08±0.29 days, P=0.0002). CONCLUSION After adjusting for comorbidities and perioperative factors, such as preoperative sepsis, higher ASA class and higher transfusion rates in the open group, laparoscopic ileocolic resection for Crohn's disease was found to be a safer choice than the open approach, resulting in fewer complications and length of stay. All other things being equal, such patients should be offered the laparoscopic approach as a first-choice option.
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Affiliation(s)
- Y Lee
- Division of Colorectal Surgery, Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, New York 14642, USA
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41
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Fleming FJ, Kim MJ, Gunzler D, Messing S, Monson JRT, Speranza JR. It's the procedure not the patient: the operative approach is independently associated with an increased risk of complications after rectal prolapse repair. Colorectal Dis 2012; 14:362-8. [PMID: 21692964 DOI: 10.1111/j.1463-1318.2011.02616.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
AIM This study compares 30-day outcomes following rectal prolapse repair, examining potential surgical and patient factors associated with perioperative complications. METHOD Using the NSQIP database, patients with rectal prolapse were categorized by surgical approach to repair (perineal or abdominal) and abdominal cases were further subdivided by procedure (resection compared with rectopexy alone). Univariate and multivariate analyses compared major and minor complication rates between the groups. RESULTS Of 1275 patients, the perineal group (n=706, 55%) was older, with more comorbidity, than those undergoing an abdominal procedure. There were fewer minor (odd ratio (OR)=0.35; 95% confidence interval (CI), 0.20-0.60; P=0.0038) and major complications (OR=0.46; 95% CI, 0.31-0.80; P=0.0038) in the perineal compared with the abdominal cohort. There was a significant increase in major complications amongst patients undergoing a resection compared with rectopexy only (OR=2.15; 95% CI, 1.10-4.41; P=0.0299). There was no difference in major complications between abdominal rectopexy and a perineal approach, but the latter had a lower chance of minor complications (OR=0.47; 95% CI, 0.24-0.94; P=0.0287). CONCLUSION A perineal approach is safer than an abdominal approach to the treatment of rectal prolapse. Regarding an abdominal operation, rectopexy has fewer major complications than resection.
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Affiliation(s)
- F J Fleming
- Division of Colorectal Surgery, University of Rochester Medical Center, Rochester, New York 14642, USA.
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42
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Ascher JM, Bates W, Ng J, Messing S, Wyatt J. Assessment of xylazine for euthanasia of anoles (Anolis carolinensis and Anolis distichus). J Am Assoc Lab Anim Sci 2012; 51:83-87. [PMID: 22330873 PMCID: PMC3276971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 05/31/2011] [Revised: 08/12/2011] [Accepted: 09/13/2011] [Indexed: 05/31/2023]
Abstract
Intracoelomic (IC) injection of xylazine was evaluated as a chemical euthanasia method for Anolis lizards (Anolis carolinensis or Anolis distichus). Lizards were allocated into 5 groups of 10 animals each. Each group was euthanized by one of these methods: 10 mg xylazine (100 mg/mL) IC; 10 mg xylazine and 0.5 mg acepromazine (10 mg/mL) IC; 10 mg xylazine IC followed by intracardiac injection of 0.1 mEq KCl (2 mEq/mL) once heart beats were no longer discernable by Doppler; 500 mg/kg 1% NaCO(3)-buffered MS222 solution IC followed by IC injection of 0.1 mL unbuffered 50% (v/v) MS222 solution (experimental groups); and 1.95 mg sodium pentobarbital, diluted 1:10 in sterile water (38.9 mg/mL) given IC (control group). Compared with those given sodium pentobarbital or MS222, lizards euthanized by using xylazine showed prolonged persistence of purposeful movement after cardiac arrest. Therefore, xylazine is not an acceptable alternative euthanasia agent for use in anoles.
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Affiliation(s)
- Jill M Ascher
- Department of Comparative Animal Medicine, University of Rochester, Rochester, NY, USA.
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43
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Wan C, Tu X, Messing S, Li X, Yang Z, Zhao X, Gao L, Yang Y, Pan J, Zhou Z. Development and validation of the general module of the system of quality of life instruments for chronic diseases and its comparison with SF-36. J Pain Symptom Manage 2011; 42:93-104. [PMID: 21530153 DOI: 10.1016/j.jpainsymman.2010.09.024] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2010] [Revised: 09/21/2010] [Accepted: 09/25/2010] [Indexed: 11/12/2022]
Abstract
CONTEXT Quality of life (QOL) for patients is now a worldwide concern, but there are few specific instruments developed by modular approach to measure outcomes in chronic diseases. OBJECTIVES This study aimed to develop and validate the System of Quality of Life Instruments for Chronic Diseases--General Module (QLICD-GM). METHODS Based on the World Health Organization's definition of QOL and programmed decision procedures, the QLICD-GM was developed using focus group discussions, pilot tests of 201 cases, and field tests of 620 cases representing seven different chronic diseases. The number of items in the final version was reduced to 30 from a 73-item pool, and the psychometric properties of the scale were evaluated by indicators, such as validity and reliability coefficients, standardized response mean, and statistical methods of correlational analysis, t-tests, and structural equation modeling. RESULTS Correlational and structural equation model analyses confirmed good construct validity with root mean square error of approximation of 0.0606, nonnormed fit index of 0.941, and comparative fit index of 0.947. Test-retest reliability coefficients for all domains and facets were higher than 0.70, with a range of 0.71-0.92, and the internal consistency alphas for most domains and facets were higher than 0.65 (ranging from 0.52 to 0.89). All domains and overall scores of the QLICD-GM had a statistically significant change after treatment, with moderate effect size. CONCLUSION The QLICD-GM has good validity, reliability, and better responsiveness compared with the SF-36® Health Survey and can be used as the general module for chronic diseases.
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Affiliation(s)
- Chonghua Wan
- School of Humanities and Management, Guangdong Medical College, Dongguan, Guangdong, People's Republic of China.
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44
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Liebman SE, Lamontagne SP, Huang LS, Messing S, Bushinsky DA. Smoking in dialysis patients: a systematic review and meta-analysis of mortality and cardiovascular morbidity. Am J Kidney Dis 2011; 58:257-65. [PMID: 21664017 DOI: 10.1053/j.ajkd.2011.03.025] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2010] [Accepted: 03/23/2011] [Indexed: 11/11/2022]
Abstract
BACKGROUND Cigarette smoking is associated with increased cardiovascular morbidity and mortality in the general population, but the effect of smoking on these outcomes in the dialysis population is less well studied. STUDY DESIGN Systematic review and meta-analysis of cohort studies. SETTING & POPULATION Adults treated with long-term hemodialysis or peritoneal dialysis. SELECTION CRITERIA FOR INCLUDED STUDIES: Cohort studies of unselected dialysis patients reporting the association between smoking status and cardiovascular morbidity and/or mortality. PREDICTOR Smoking status (determined using patient report). OUTCOMES (1) All-cause or cardiovascular mortality; (2) incident cardiovascular events. RESULTS We identified 34 studies that fulfilled all inclusion criteria. Of these, 26 studies provided data for smoking and mortality and 10 (n = 6,538) were included in a meta-analysis. The pooled HR for all-cause mortality in smokers compared with nonsmokers was 1.65 (95% CI, 1.26-2.14; P < 0.001). 11 studies provided data for smoking and incident cardiovascular events; 5 (pooled n = 845) were included in a meta-analysis. The pooled HR for composite cardiovascular events in smokers compared with nonsmokers was 1.01 (95% CI, 0.98-1.05; P = 0.4). LIMITATIONS Data for these meta-analyses were heterogeneous. Few individual studies assessed smoking as the primary variable of interest. CONCLUSIONS Active smoking is associated with a significant increase in all-cause mortality in dialysis patients, although there was no corresponding increased risk of cardiovascular events.
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Affiliation(s)
- Scott E Liebman
- Division of Nephrology, University of Rochester Medical Center, NY, USA.
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45
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Rothschild J, Thomer M, Messing S, Mayer R. 805 PREDICTIVE FACTORS OF PAIN SEVERITY IN PATIENTS WITH INTERSTITIAL CYSTITIS/BLADDER PAIN SYNDROME. J Urol 2011. [DOI: 10.1016/j.juro.2011.02.623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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46
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Wan C, Fang J, Jiang R, Shen J, Jiang D, Tu X, Messing S, Tang W. Development and validation of a quality of life instrument for patients with drug dependence: comparisons with SF-36 and WHOQOL-100. Int J Nurs Stud 2011; 48:1080-95. [PMID: 21397228 DOI: 10.1016/j.ijnurstu.2011.02.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2010] [Revised: 01/30/2011] [Accepted: 02/06/2011] [Indexed: 10/18/2022]
Abstract
AIM Our goal was to develop a self-administered quality of life scale for patients with drug addiction/dependence (QOL-DA) and compare it with the SF-36 and the WHOQOL-100. METHODS Employing theory and methodology of rating scale construction, a self-administered quality of life instrument for individuals with drug dependence QOL-DA was developed and evaluated utilizing responses from 212 drug-dependent subjects at the Kunming Municipal Mandatory Detoxification and Rehabilitation Center in China. Quality of life was measured using the SF-36, WHOQOL-100 and QOL-DA three times during the detoxification. RESULTS Test-retest reliability in the domains of physical function, psychological function, social function and toxicity were 0.82, 0.64, 0.78, and 0.76, respectively. Cronbach's coefficient α for the 4 domains was 0.87, 0.89, 0.93 and 0.86, respectively. Correlations and factor analysis showed good construct validity. Criterion-related and convergent validity was confirmed by using the SF-36 and the WHOQOL-100 simultaneously. The instrument does show the change in QOL after two weeks of detoxification with higher standardized response mean higher than that of SF-36 and WHOQOL-100. CONCLUSION The instrument developed has good validity, reliability and better responsiveness than instruments currently used, and can be employed effectively to measure the quality of life of individuals with drug dependence.
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Affiliation(s)
- Chonghua Wan
- School of Humanities and Management, Guangdong Medical College, Dongguan, China.
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47
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Simons E, Huang L, Messing S, Toy E. Surgery–adjuvant therapy interval in women with endometrial cancer staged with robot-assisted laparoscopy versus laparotomy. Gynecol Oncol 2011. [DOI: 10.1016/j.ygyno.2010.12.316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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48
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Kim MJ, Fleming FJ, Gunzler DD, Messing S, Salloum RM, Monson JRT. Laparoscopic appendectomy is safe and efficacious for the elderly: an analysis using the National Surgical Quality Improvement Project database. Surg Endosc 2011; 25:1802-7. [PMID: 21298549 DOI: 10.1007/s00464-010-1467-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2010] [Accepted: 09/03/2010] [Indexed: 01/10/2023]
Abstract
BACKGROUND Despite increasing use of laparoscopic appendectomy, data demonstrating outcomes of this technique exclusively among the elderly population are scarce. This study aimed to compare 30-day postoperative morbidity and length of hospital stay among elderly patients after appendectomy. METHODS Appendicitis patients older than 65 years were extracted from the National Surgical Quality Improvement Project (NSQIP) database. Demographics and rates of complications for patients undergoing open and laparoscopic appendectomies were compared. Uni- and multivariate analyses adjusted for differences between groups compared the end points of major and minor complications as well as the days of hospital stay after initial surgery. RESULTS A total of 3,335 patients underwent appendectomy, with 2,235 patients (67%) receiving a laparoscopic procedure. The open appendectomy patients were significantly older and more likely to have various preoperative comorbidities (p<0.05). No difference in median operative time between the two techniques was found. Both required 51 min (p=0.11). The open cases had higher rates of both major and minor postoperative complications than the laparoscopic cases (p<0.0001), both overall and before discharge. Multivariate analysis showed no association between operative approach and major complications, and a reduced risk of minor complications with laparoscopy. Length of surgical stay was longer for the open group than for the laparoscopically treated group (median, 4 days vs 2 days; p<0.05). After adjustment, laparoscopy still was significantly associated with a shorter hospital stay than open appendectomy (p<0.0001). CONCLUSIONS Laparoscopic appendectomy is a safe procedure for elderly patients. During the 30-day postoperative period, no correlation with major complications was found, and the findings showed a beneficial association with regard to minor complications. After adjustment for perioperative factors, laparoscopy is associated with a shorter hospital stay than open appendectomy.
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Affiliation(s)
- Michael J Kim
- Division of Colorectal Surgery, Department of Surgery, University of Rochester, Rochester, NY, USA.
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49
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Keen JN, Austin M, Huang LS, Messing S, Wyatt JD. Efficacy of soaking in 70% isopropyl alcohol on aerobic bacterial decontamination of surgical instruments and gloves for serial mouse laparotomies. J Am Assoc Lab Anim Sci 2010; 49:832-837. [PMID: 21205449 PMCID: PMC2994051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 03/10/2010] [Revised: 05/05/2010] [Accepted: 05/17/2010] [Indexed: 05/30/2023]
Abstract
Rodent surgeries in biomedical research facilities are often performed in series. This practice presents many challenges to maintaining aseptic technique between animals. Here, we examined using soaking in 70% isopropyl alcohol for aerobic bacterial decontamination of surgical instruments and gloves used in a series of as many as 10 mouse laparotomy surgeries. These surgeries were performed on mice that were euthanized immediately prior to the procedure. Instruments and gloves were cultured before and after each procedure to determine the presence of aerobic bacterial contamination. To assess the efficacy of the decontamination protocol, culture results were grouped by procedure and then paired (before soak and after soak) for analysis using McNemar test at an α level of 0.05. In addition, by using the Fisher exact test, this modified aseptic method was compared with strict aseptic technique, for which autoclaved instruments and sterile surgical gloves were used for each procedure. In this study, we observed that the modified aseptic technique using 70% isopropyl alcohol soaks pre- vented aerobic bacterial contamination of instruments and gloves for as many as 5 mice.
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Affiliation(s)
- Jessica N Keen
- Department of Comparative Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA.
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50
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Reddy SM, Anandarajah AP, Fisher MC, Mease PJ, Greenberg JD, Kremer JM, Reed G, Chen R, Messing S, Kaukeinen K, Ritchlin CT. Comparative analysis of disease activity measures, use of biologic agents, body mass index, radiographic features, and bone density in psoriatic arthritis and rheumatoid arthritis patients followed in a large U.S. disease registry. J Rheumatol 2010; 37:2566-72. [PMID: 20843908 DOI: 10.3899/jrheum.100483] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To compare disease activity, radiographic features, and bone density in psoriatic arthritis (PsA) and rheumatoid arthritis (RA) matched cohorts. METHODS Disease activity and radiographic data in the Consortium of Rheumatology Researchers of North America database from 2001 to 2008 were compared for 2481 patients with PsA and 17,107 patients with RA subsequently matched for age, gender, and disease duration. Radiographic outcomes included presence of erosions, and joint deformity. In addition, bone mineral density (BMD) scores for lumbar spine (L-spine) and femoral neck were compared using the same matching criteria plus weight and smoking status. RESULTS Tender (4.5 vs 3.4, p < 0.001) and swollen (4.4 vs 2.9, p < 0.012) joint counts, and modified Health Assessment Questionnaire scores were significantly higher (0.4 vs 0.3, p < 0.001) in patients with RA compared with patients with PsA. Patient general health and pain scores were also higher in patients with RA vs patients with PsA. Joint erosions (47.4% vs 37.6%, p = 0.020) and deformity (25.2% vs 21.6%, p = 0.021) were more prevalent in RA than PsA. In multivariate analysis, a reduced prevalence of erosions in PsA vs RA was noted (OR 0.609, p < 0.001). After matching, T-scores for L-spine (-0.54 vs -0.36, p = 0.077) and femoral neck (-0.88 vs -0.93, p = 0.643) were similar in patients with RA and patients with PsA, although body weight was a major confounder. CONCLUSION The level of disease activity and radiographic damage was significantly higher for RA vs PsA subjects, although the magnitude of differences was relatively small. BMD levels were comparable between cohorts. Outcomes in patients with PsA and patients with RA may be more similar than previously reported.
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Affiliation(s)
- Soumya M Reddy
- New York University School of Medicine-Hospital for Joint Diseases, New York, USA.
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